Madhava Nidana Chapter 37 Vriddhi Nidanam

This article explains Madava nidana 37th chapter “Vriddhi Nidanam”. Causes, pathology and symptoms of Vriddhi are explained in this chapter.
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Table of Contents

Vriddhi Samprapti, Bheda

Pathogenesis and types of Vriddhi
Pathogenesis – Vaata undergoing increase moves downwards through the groins to the scrotum and causes derangement of the vessels of the scrotum and produces enlargement of the scrotum. This condition is associated with oedema and pain and is called vriddhi.
Types of Vriddhi – Vriddhi is said to be of 7 types – one from each of the three doshas, one from rakta (blood), one from meda (fat), one from mutra (urine) and the seventh one from antra (intestines).
Even the mutraja and antraja are mainly due to vata, though named separately after their causes. (1-2)
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Vriddhi Lakshanas

Symptoms of types of Vriddhi
Vataja Vriddhi – In vātaja vriddhi, the scrotum resembles a bag filled with air on touch and is rough. There will be pain without any apparent reason.
Pittaja Vriddhi – In pittaja víddhi, the scrotum resembles a ripe udumbara (wild fig, Ficus glomerata) fruit. The swelling is accompanied with burning sensation, increased heat and tendency to undergo suppuration quickly.
Kaphaja Vriddhi – In kaphaja vriddhi, the scrotum is cold to touch, heavy and unctuous. There is itching, the scrotum is hard on touch and is accompanied with very little pain.
Raktaja Vruddhi – In raktaja vriddhi caused by vitiated blood, the swelling of the scrotum is surrounded by (studded with) black coloured eruptions (blisters). This condition will have all the symptoms of pittaja vriddhi.
Medoja Vriddhi – In Medaja vriddhi caused by vitiated fat, all symptoms of kaphaja vriddhi are seen. The scrotal swelling is soft and resembles (big) a tala fruit (wild palm).
Mutraja Vruddhi – This type of vriddhi occurs in persons who are habituated in suppressing the natural urge of urination. The scrotum is filled with fluid and resembles a water bag filled with fluid and fluctuates while walking. The swelling of the scrotum is soft and is painful. When the scrotum is moved it produces pain similar to that of mutrakrchra (dysuria – difficulty in urination). (3-6)

Sanskrit Verses

Antra Vruddhi

Below mentioned are the etiological factors of antra vriddhi –

Excessive consumption of foods which increase (or tends to increase) vata
Sitting in a tub of cold water regularly and for prolonged periods (tub bath)
Withholding (forcibly controlling) the impending natural body urges or forcibly trying to create the urges which are not present
Carrying heavy loads
Excessive walking for long distances
Abruptly moving the body parts (like doing acrobatics) and such other tiresome activities

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Pathogenesis – The vata gets aggravated due to the above said etiological factors. This aggravated vata would constrict a part of the intestine and brings it down into the scrotum causing its enlargement. A swelling resembling a cyst is formed in the groin. When this condition is neglected the vata further gets aggravated and moves the intestine even downwards and causes distension, pain and stiffness in the scrotum. On pressing, the intestine produces sounds and moves back into its position but soon come back into the scrotum once the pressure is released. This condition is called as antraja vriddhi. The symptoms of antra vriddhi are similar to those of vataja vriddhi and this condition is incurable. (7-10)